The Value of Automated Follicle Volume Measurements in IVF/ICSI

Abstract

Background/Aims: The objective of this literature study is to investigate the place of recent software technology sonography-based automated volume count (SonoAVC) for the automatic measurement of follicular volumes in IVF/ICSI. Its advantages and disadvantages and potential future developments are evaluated.Methods: A total of 74 articles were read via a PubMed literature study. The literature study included 53 articles, 32 of which for the systematic review.Results: The SonoAVC software shows excellent accuracy. Comparing the technology with the “golden standard” two-dimensional (2D) manual follicle measurements, SonoAVC leads to a significantly lower intra- and inter-observer variability. However, there is no significant difference in clinical outcome (pregnancy rate). We noted a significant advantage in the time gained, both for doctor and patient. By storing the images, the technology offers the possibility of including a quality control and continuous training and further standardization of follicular monitoring can be expected. Ovarian reserve testing by measuring the antral follicle count with SonoAVC is highly reliable.Conclusion: This overview of previously published literature shows how SonoAVC offers advantages for clinical practice, without losing any accuracy or reliability. Doctors should be motivated to the general use of follicular volumes instead of follicular diameters.

Assessing ovarian response: antral follicle count versus anti-Müllerian hormone

“…Obtaining an AFC is already associated with costs for the ultrasound machine and ultrasound technician; increased costs associated with three-dimensional ultrasound may be prohibitive. Furthermore, three-dimensional imaging has not been shown to improve clinical results, and, as with standard twodimensional imaging, image quality can vary depending on the patient (Vandekerckhove et al, 2014).…”

“…Poor-quality images may affect the reliability of AFC, particularly in women with ovarian cysts, fibroids, or scars from previous surgeries. The choice of ultrasound machine also has an impact on image quality Vandekerckhove et al, 2014). In addition, AFC tends to overestimate the true number of FSH-sensitive follicles and oocytes retrieved, perhaps because it also includes non-viable atretic follicles of the same size.…”

“…Although studies are limited, automated three-dimensional ultrasound imaging has been shown to reduce intra-and interobserver variability, thus providing more reliable AFC measurements in a shorter amount of time Deb et al, 2009Deb et al, , 2010Deb et al, , 2011Jayaprakasan et al, 2010). Follicular measurement data can also be stored for future review and training of technicians and investigators (Vandekerckhove et al, 2014). Further evaluation of this technology and associated costs, however, are needed before regular use in the clinic Iliodromiti et al, 2014a).…”

Fertility Treatment Outcomes After Follicle Tracking With Standard 2‐Dimensional Sonography Versus 3‐Dimensional Sonography‐Based Automated Volume Count: Prospective Study

“…Furthermore, the individualized color code for each hypoechoic area eliminates the possibility of measuring the same follicle more than once. The program also shortens the time needed for follicular assessment, thereby improving the clinical work flow …”

“…The program also shortens the time needed for follicular assessment, thereby improving the clinical work flow. [7][8][9][10][11][12][13] Thus far, only 2 prospective studies have addressed the impact of the new automated follicular diameter measurement on fertility outcomes. 14,15 Raine-Fenning et al 14 showed no significant difference between manual and automated follicle tracking in terms of the number of oocytes retrieved, number of mature oocytes, or pregnancy rate.…”